• Hip & pelvis
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• v.35 no.1
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• pp.1-5
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• 2023

Piriformis syndrome is a common differential diagnosis related to sciatica. The following review provides a concise synopsis of the diagnosis, management, history, and alternatives to diagnosis of piriformis syndrome. A search of the literature for research articles related to piriformis syndrome and associated differential diagnosis of sciatica was conducted. A thorough review of the included articles found that the condition known as piriformis syndrome is over-diagnosed and that potential anatomic and biomechanical variations originating in the pelvic region might be related to the complaint of sciatica. The criteria for diagnosis are based on findings from both physical examination and radio imaging. Piriformis syndrome resembles a variety of clinical conditions; therefore, conduct of future studies should include development of a validated method for evaluation as well as clinical criteria for diagnosis of piriformis syndrome.

• Investigative Magnetic Resonance Imaging
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• v.23 no.2
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• pp.142-147
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• 2019

Piriformis syndrome caused by an accessory belly of the piriformis muscle is very rare. Only a few cases have been reported. Here, we report a case of piriformis syndrome resulting from an extremely rare type of accessory belly of the piriformis muscle originated at the proximal third portion of the main piriformis muscle and attached separately to the greater trochanter inferior to the insertion of the main piriformis muscle. A definitive diagnosis of piriformis syndrome was made based on magnetic resonance imaging and magnetic resonance neurography findings that were consistent with results of nerve conduction study and needle electromyography.

• The Korean Journal of Pain
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• v.23 no.1
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• pp.88-91
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• 2010

The piriformis syndrome is a condition allegedly attributable to compression of the sciatic nerve by the piriformis muscle. Recently, magnetic resonance neurography and electrophysiologic study have helped to diagnose piriformis syndrome. High dose radiotherapy could induce acute and delayed muscle damage. We had experienced piriformis syndrome with fatty atrophy of piriformis muscle after radiotherapy for recurrent cervical cancer.

• The Korean Journal of Pain
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• v.9 no.1
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• pp.120-125
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• 1996

It has been reported by some authors that caudal block with local anesthetic and steroid is the most effective therapeutic modality for piriformis syndrome; and the incidence ratio of female to male being 6 to 1. We treated 89 patients with piriformis syndrome in 1995. From those clinical experiences and anatomical studies we heave arrived at several conclusions different from other authors. Our results indicate the following: 1) Piriformis syndrome does not provoke lower back pain. 2) Our rate of incidence showed a very different profile as results showed a female to male ratio of 33:56. 3) Releasing the compressed nerves(gluteal, sciatic) with spasmolytic treatment on the piriformis muscle itself is thought to be the only therapeutic modality for piriformis syndrome.

• Clinical Pain
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• v.19 no.1
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• pp.49-53
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• 2020

Piriformis muscle syndrome is a condition that causes direct muscle pain around piriformis muscle or sciatica from irritated sciatic nerve and the diagnosis remains debatable. The main treatment is symptomatic relief from conservative therapy such as medication and piriformis stretching exercise, and various therapeutic injections including local anesthetic, corticosteroid, botulinum toxin can be considered for diagnostic and therapeutic purposes. In this case, a 54-year-old male who had sciatica and gait disturbance showed piriformis muscle hypertrophy in the pelvis MRI. From imaging studies, electrodiagnostic study and physical examination, he was diagnosed with piriformis muscle syndrome. He underwent trigger point injection and botulinum toxin injection into the piriformis muscle, and pain and gait disturbance significantly improved. This case reports a case of piriformis muscle syndrome with clinical symptom of gait disturbance, which was improved by botulinum toxin injection.

• Journal of Physiology & Pathology in Korean Medicine
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• v.24 no.5
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• pp.898-902
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• 2010

This study is performed to report that oriental medical treatment was effective to the patient with piriformis syndrome after traffic accident. The patient was diagnosed as piriformis syndrome by considering clinical symptom, clinical history, physical examination, radiologic study and NCV EMG study. We applied acupuncture, herbal medicine, cupping, Chuna manipulation and exercise to the patient. After treatment, VAS decreased, and physical examination sign was disappeared. This result suggest that oriental medical treatment can be effective to piriformis syndrome.

• Journal of Korean Medicine Rehabilitation
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• v.20 no.2
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• pp.209-217
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• 2010

This study was performed to report the effectiveness of oriental medical treatment and muscle energy techniques on a patient with piriformis syndrome. The patient was diagnosed as piriformis syndrome and treated with acupuncture, herb medicine, physical therapy and muscle energy techniques. We have evaluated curative efficacy with measuring changes of visual analogue scale and physical examination according to period of hospitalization. After treatment, pain and visual analogue scale decreased. Physical examinations were recuperated nearly to normal findings and ambulation was improved. These results suggest that oriental medical treatment and muscle energy techniques were effective on patient with piriformis syndrome.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.16 no.2
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• pp.39-45
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• 2021

Objectives The purpose of this study was to assess the effect of fascia chuna therapy in the treatment of piriformis syndrome. Methods A literature search was conducted using 8 databases to identify all randomized controlled clinical trials (RCTs) that investigated fascia chuna therapy as a treatment for piriformis syndrome. The selected studies are analyzed the risk of bias through Cochrane risk of bias tool. Results Among 37 articles that were searched, 3 RCTs met our inclusion criteria and were included in this analysis. These studies demonstrated positive results of Fascia Chuna Therapy with respect to the reduction of pain scale and functional scale compared with other treatment methods. Conclusions Based on results, fascia chuna therapy could be effective in piriformis syndrome. However there are limitations that the number of selected studies was small and risk of bias was unclear. More well-designed RCTs are required to provide clearer evidence.

• The Korean Journal of Pain
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• v.8 no.1
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• pp.149-151
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• 1995

Piriformis syndrome is a syndrome of low back and leg radiating pain thought to be due to a chronic contracture of the piriformis muscle that causes irritation of the sciatic nerve. The piriformis muscle is a flat pyramidal muscle, an external rotator and abductor of the hip, originating from the front of the sacrum and inner aspect of the sacroiliac joint, then passes laterally out of the sciatic notch to attach posteriorly to the greater trochanter of the femur, the sciatic nerve passes between the two bellies of the muscle. Mechanical irritation of the sciatic nerve by an inflammatory reaction of the piriformis muscle and its fascia at this pelvic level causes pain to radiate in the dermatomal regions of the nerve roots similar to that disk entrapment. diagnosis of piriformis syndrome is made primary on the basis of history and clinical examination. The incidence is considerably higher in women, with the reported ratio of women to men of 6:1. These patients frequently present with associated symptoms of pelvic pain and/or dyspareunia. Symptoms are usually unilateral but occasionally be bilateral. We had a 42 year-old woman patient with low back and left leg radiating pain and dyspareunia treated by caudal steroid and local anesthetic.

• The Korean Journal of Pain
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• v.8 no.2
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• pp.341-346
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• 1995

Piriformis Syndrome is characterized by pain of the low back, groin, perineum, buttock, hip, posterior thigh, leg and foot. Symptoms are aggravated by sitting, prolonged combination of hip flexion, adduction, the medial rotation, or by activity. In addition, patient may complain of painful swelling of the limb and sexual dysfunction-dyspareunia in female, and impotence in male. It currently appears that three specific conditions may contribute to the piriformis syndrome: (a) myofascial pain; (b) nerve and vascular entrapment; (c) dysfunction of the sacroiliac joint. The important keys of diagnosis are history and physical examination. There is no known objective diagnostic method. We described the clinical features of four cases of piriformis syndrome and reviewed foreign literature.